Incisional ventral hernias are common complications of abdominal surgery. The present study was conducted to assess transverse abdominal release and posterior component separation in large incisional hernia. Materials & Methods:76 patients with incisional hernia of both genders were divided into 2 groups of 38 each. Group I patients were subjected to PCS-TAR using standard technique and group II (control) patients were subjected to conventional onlay mesh repair. Parameters such as wound complications (seroma, wound discharge/ gaping, flap necrosis), intraabdominal pressure, duration of hospital stay, quality of life, and recurrence rate etc. was recorded. Results: Group I had 18 males and 20 females and group II had 21 males and 17 females. The mean duration of surgery (mins) was <100 seen in 14 and 28 and >100 in 24 and 10. Defect size (cm) was 10 seen in 12 and 8, 11 in 10 and 11, 12 in 8 and 9, 13 in 5 and 6 and 14 cm in 3 and 4. Comorbidities observed were diabetes seen in 4 and 2, hypertension in 3 and 6 and both DM/ HTN in 7 and 8. Wound discharge was positive in 16 and 17, wound gaping waspositive in 11 and 16, flap necrosis was positive in 0 and 9, intraabdominal pressure was <9 in 34 and 25 and >10 in 4 and 13 in group I and II respectively. The difference was significant (P< 0.05). The mean pain score was 32.5 in group I and 49.1 in group II, post- op hospital stay was 11.3 days in group I and 12.7 days in group II and recurrence rate was 1 in group I and 2 in group II. The difference was significant (P< 0.05). Conclusion: Posterior component separation results in significant reduction in flap necrosis, intra-abdominal pressure, wound debridement and post op hospital stay